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The article discusses the need to turn attention to issues that are critical to the future of public deliberation practice such as broadening the reach and scale of public deliberation, increasing acceptability to policymakers, and integrating it into policy decisions. Public deliberation efforts must be undertaken on a bigger scale. Public deliberations that work inside the system to be effective, must be formed, timed, and located in ways that can productively relate to policy processes.

The article discusses the concept of public deliberation and that is value-based in that it seeks to determine what ought to be done in response to a particular issue or a challenge that requires citizens to identify, clarify, and weigh the tensions among their views and the values underlying them; justify them to others; and set priorities. The need to understand that public deliberation is especially transformative wherein insight is gained is highlighted.

Gives a brief description of the process, the outcome, and the effects of the Romanow Commission on the Future of Health Care in Canada, which entailed a dialogue with representative cross-sections of the Canadian population. View that the legitimacy and sustainability of any major policy decisions depends on how well it reflects the underlying values of the public; Mention of ChoiceWork dialogues, which were created by Viewpoint Learning and based on the research of its chairman, Daniel Yankelovich; Way that the dialogues engage members of the public on important issues before the decisions are made; Impact of combining the roles of citizens as taxpayers and patients on the debate; Opinion that engaging the public in this way is more costly than polling, but is essential when making difficult decisions. INSETS: Summary points;Box 1: Basic steps in a ChoiceWork dialogue project;Box 2: Four scenarios for the future of health care in Canada;Box 3: Participants' own words (extracted from session...